Background of the invention
Field of the invention:
[0001] This invention relates to an improved heat exchanger-incorporated hollow fiber type
artificial lung.
Description of prior art:
[0002] Generally when blood is drawn out of a patient's body and oxygenated externally as
during a cardiac operation, an artificial lung is used in the extracorporeal circuit.
When the cardiac operation necessitates use of slightly or medially low temperatures
or extremely low temperatures, the blood must be cooled to the order of 35° to 20°C
at the outset of the circulation of blood through the extracorporeal circuit. Conversely
when the extracorporeal circulation is to be terminated, the blood must be heated
to a temperature substantially equal to the patient's body temperature. For the purpose
of this regulation of blood temperature, the extracorporeal circuit is provided with
a heat exchanger. This heat exchanger may be utilized for the purpose of maintaining
the warmth of blood when the blood is desired to be circulated at the normal body
temperature.
[0003] Conventionally in the extracorporeal circuit, the artificial lung and the heat exchanger
have been incorporated independently of each other and interconnected with a connection
tube. As a consequence of this setup, the assemblage of the circuit has proved complicate
and the connection between the artificial lung and the heat exchanger has been made
incorrectly, though not frequently. Moreover since the connection tube is inevitably
provided with two independent blood ports (one for the heat exchanger and the other
for the artificial lung), it has called for a large volume of priming. Further the
operation of priming itself has been quite difficult because the removal of bubbles
from the blood during the course of priming must be performed separately for the artificial
lung and the heat exchanger.
[0004] As a partial solution of this problem, a superposed membrane type artificial lung
incorporating a heat exchanger has been disclosed in Japanese Patent Publication (Kokoku)
No. 2982/ 1980. Since the artificial lung part and the heat exchanger part are both
of a superposed membrane type, the artificial lung is difficult to manufacture. Moreover
the artificial lung of such a membrane type admits of heavy personal error and has
a possibility of entailing dispersion of quality among artificial lungs manufactured
at one and the same factory.
[0005] To solve the problem, I formerly proposed (see EP-A-0046583, this document falls
under Art 54(3) EPC for all the designated Contracting States) a heat exchanger-incorporated
hollow fiber type artificial lung comprising a hollow fiber type artificial lung part
having a plurality of bundles of gas-exchange hollow fiber membranes contained in
a first tubular housing and a shell-and-tube type heat exchanger part having a plurality
of tubes contained in a second tubular housing, with the aforementioned artificial
lung part and the aforementioned heat exchanger part coaxially connected to each other
through the union of the aforementioned first and second tubular housings. In this
artificial lung, the first and second housing may have connecting ends of an identical
diameter. These connecting ends have screw threads cut in mutually opposite directions.
The first and second housings are coaxially connected to each other by virtue of a
connecting screw ring fitted across the outer sides of the aforementioned connecting
ends so as to define a blood chamber between adjacent partitions of the housings by
the medium of an annular spacer having sealing O-rings.
[0006] The artificial lung adopting such mode of connection as described above is effective
for a short period of time. When this artificial lung as a product is required to
guarantee good performance for a long time, it may possibly pose some problem. If
the screw threads in the connecting end should come loose, since one of them spirals
opposite the other, the user could not easily retighten them. When he dares to retighten
such loose screw threads, there is a possibility that he will unwittingly cause them
to come apart each other entirely. In the hope of precluding this detestful fault,
I studied the feasibility of a method of fusing the reverse screw ring fast in position,
only to find that the potting member of the artificial lung would collapse on prolonged
exposure to compression and the O-ring made of rubber would avoid following the collapse
and induce leakage. When the O-ring separates from the groove exclusively for its
own insertion, it will induce leakage afterward.
[0007] An object of this invention is to provide a heat exchanger-incorporated hollow fiber
type artificial lung provided with a highly reliable, safe connection structure.
Summary of the invention
[0008] The object described above is attained by a heat exchanger-incorporated hollow fiber
type artificial lung comprising a hollow fiber type artificial lung part composed
of a first housing, a hollow fiber bundle of a plurality of gas-exchange hollow fibre
membranes mutually separated and parallelly disposed within the aforementioned first
housing in the longitudinal direction of the housing, a first and a second partition
water-tightly supporting the aforementioned hollow fiber membranes at the opposite
ends thereof in a state not blocking the openings of the membranes and further defining
an oxygen chamber in conjunction with the inner wall of the aforementioned first housing
and outer surfaces of the aforementioned hollow fiber membranes, an oxygen inlet and
an oxygen outlet communicating with the aforementioned oxygen chamber, and a blood
passage communicating with the cavities in the aforementioned hollow fiber membranes
at the ends thereof at the side of said first partition remote from said oxygen chamber,
and a shell-and-tube type heat exchanger part composed of a second housing, a plurality
of tubes mutually separated and parallelly disposed inside the aforementioned second
housing in the longitudinal direction, a third and a fourth partition water-tightly
supporting the aforementioned tubes at the opposite ends thereof in a state not blocking
the openings of the tubes and further defining a heat-exchange medium chamber in conjunction
with the inner wall of the aforementioned second housing and the outer surfaces of
the aforementioned tubes, a heat-exchange medium inlet and a heat-exchange medium
outlet communicating with the aforementioned heat-exchange medium chamber, and a blood
passage communicating with the cavities inside the aforementioned tubes at the ends
thereof at the side of the aforementioned fourth partition remote from the aforementioned
heat-exchange medium chamber, wherein the aforementioned first housing of the aforementioned
artificial lung part and the aforementioned second housing of the aforementioned heat
exchanger part are coaxially connected to each other so as to give rise to a blood
chamber between the aforementioned second partition and third partition, the aforementioned
first and second housing having connecting ends formed respectively thereon so as
to be connected to each other through the medium of an annular spacer by virtue of
a connecting ring fitted across the outsides of the aforementioned connecting ends
and, through at least two injection holes bored in the aforementioned connecting ring
so as to communicate with a vacant space defined by the aforementioned connecting
ring, the aforementioned second and third partitions and the aforementioned annular
spacer, adhesive agent having been injected to fill up the vacant space.
[0009] In a preferred embodiment of this invention, the first and second housings possess
their own connecting ends of an identical diameter and these connecting ends have
screw threads cut in oppositely spiralling directions and are connected with a connecting
screw ring. The annular spacer adapted to form the blood chamber between the second
and third partitions has a protuberance formed on the periphery thereof. A gap formed
between this protuberance and the second partition and a gap formed between the protuberance
and the third partition each have an 0-ring inserted therein.
[0010] The hollow fiber membrane is formed of polyolefin, for example. Generally, this polyolefin
hollow fiber membrane contains pores of an average diameter of about 200 to about
2,000 A at a porosity of about 20 to about 80%. The average diameter of the pores
in the hollow fiber membrane is determined as follows. First, the inner and outer
surfaces of a given sample membrane are observed in conjunction with standard particles
(such as, for example, "Uniform Latex Particles" made by the Dow Chemical Company)
under a scanning electron microscope (made by Nihon Denshi Kabushiki Kaisha) at about
10,000 magnifications to compare the fine pores in the sample membrane with the standard
particles and determine the diameters of such pores based on the size of the standard
particles. Then, the diameters of the pores having a substantially circular shape
are averaged and the value thus found is noted as an average pore diameter. When the
pores have an elliptic shape, their major diameters and minor diameters are measured
and the areas of these ellipses are calculated by the formula, S=na
b/4 (wherein, S denotes the area, a the major diameter, and b the minor diameter). The
diameters of the pores are then calculated by assuming the found areas as areas of
circles. They are averaged. The value so found is noted as the average pore diameter.
In other words, the average diameter of such elliptic pores represents a geometric
mean of major and minor diameters.
[0011] Further in the preferred embodiment of this invention the first housing is provided
on the inner wall thereof with a constricting part adapted to squeeze the bundles
of hollow fibre membranes at a point halfway along the entire length of the bundles.
Brief description of the drawings
[0012]
Fig. 1 is a partially sectioned side view of one preferred embodiment of the heat
exchanger-incorporated hollow fiber type artificial lung according to this invention,
Fig. 2 is an enlarged cross section of an end portion of the heat exchanger part illustrated
in Fig. 1, and
Fig. 3 is a partially sectioned side view of another embodiment of the present invention.
Preferred embodiment of the invention
[0013] Now, one preferred embodiment of the present invention will be described below with
reference to the accompanying drawing.
[0014] As illustrated in Fig. 1, the heat exchanger-incorporated hollow fiber type artificial
lung of this invention has a hollow fiber type artificial lung part A and a heat exchanger
part B integrally connected to each other. The artificial lung part A is provided
with a first housing 1. The first housing 1 is provided at the opposite ends of a
cylindrical main body 2 thereof with annular male screw thread fitting covers 3, 4.
Inside the first housing 1, a multiplicity, specifically on the order to 10,000 to
60,000 in total of gas-exchange hollow fiber membranes 5 are parallelly arranged,
while mutually separated, longitudinally to full capacity. Inside the annular fitting
covers 3, 4, the opposite ends of the gas-exchange hollow fiber membranes 5 are water-tightly
supported in position by a first partition 6 and a second partition 7 in such a manner
that the openings of the individual membranes may not be blocked. The aforementioned
partitions 6, 7 define and enclose an oxygen chamber 8 in conjunction with the outer
surfaces of the hollow fiber membranes 5 and the inner wall surfaces of the aforementioned
first housing 1. They further separate the oxygen chamber 8 from cavities formed inside
the aforementioned gas-exchange hollow fiber membranes 5 for passage of blood (not
shown).
[0015] The annular fitting cover 3 is provided with an inlet 9 for supply of oxygen and
the other annular fitting cover 4 is provided with an outlet 10 for discharge of oxygen.
[0016] The outer surface of the aforementioned first partition 6 is covered with a blood
port 11. The inner surface of the blood port 11 and the surface of the aforementioned
first partition 6 define a blood inflow chamber 12. Further, in the blood port 11
is formed an inlet 13 for blood. The blood port 11 is fastened to the fitting cover
3 with a screw ring 41. The blood port 11 is also provided with an air vent 43.
[0017] The cylindrical main body 2 of the aforementioned first housing 1 is desired to be
provided on the inner wall surface thereof with a constricting member 14 protuberating
at a position halfway along the axial length thereof. To be specific, the constricting
member 14 is integrally formed with the cylindrical main body 2 on the inner wall
side of the main body so as to squeeze the overall periphery of the hollow fiber bundle
15 comprising the multiplicity of hollow fiber membranes 5 inserted axially in the
interior of the cylindrical main body 2. Thus, the hollow fiber bundle 15 is constricted
at a point falling halfway along the axial length thereof as illustrated in Fig. 1
to form a squeezed portion 16. The packing ratio of the hollow fiber membranes 5 continuously
varies in the axial direction thereof, reaching the maximum at the center. For the
reason to be described afterward, the values of packing ratio at varying points are
desired to be as follows. First, the packing ratio in the squeezed portion 16 at the
center is about 60 to 80%, that inside the cylindrical main body 2 about 30 to 60%,
that at the opposite ends of the hollow fiber bundle 15, namely on the outside of
the partitions 6, 7 about 20 to 40%.
[0018] The hollow fiber membranes 5 are made of porous polyolefin resin such as, for example,
polypropylene resin or polyethylene resin. Among other polyolefin resins, the polypropylene
resin proves particularly desirable. These hollow fiber membranes 5 can be obtained
in a form containing numerous pores interconnecting the inside and the outside of
the partition. The inside diameter is about 100 to 1,000 pm, the wall thickness is
about 10 to 50 µm, the average pore diameter is about 200 to 2,000 A, and the porosity
is about 20 to 80%. In the hollow fiber membranes made of such a polyolefin resin,
the resistance the membranes offer to the movement of a gas therein is small and the
capacity of the membranes for gas exchange is notably high because the gas moves therein
in a voluminal flow. Optionally, the hollow fiber membranes may be made of silicone.
[0019] The hollow fiber membranes 5 made of porous polypropylene or polyethylene are not
directly used in their unmodified form in the artificial lung but are desired to have
their surfaces, which are destined to contact blood, coated in advance with an antithrombotic
material. For example, the surfaces may be treated with such a material as polyalkyl
sulfone, ethyl cellulose or polydimethyl siloxane which excels in gas permeability,
so as to be coated with a film of this material in a thickness of about 1 to 20 pm.
In this case, possible dispersion of water vapor from the blood under treatment may
be precluded by allowing the produced film of this material to cover the pores in
the membranes to such an extent that no adverse effect will be exerted on the previousness
of the hollow fiber membranes 5 to gases. Generally during the operation of the artificial
lung, the pressure on the blood side is higher than that on the oxygen side. There
are times when this relationship may be reversed for some cause or other. If this
reversal occurs, there may ensue the possibility of microbubbles flowing into the
blood. When the hollow fiber membranes have their pores coated with antithrombotic
material as described above, this possibility is completely avoided. Of course, this
coating is also useful for preventing the blood from coagulation (occurrence of microclots).
[0020] Now, the formation of the aforementioned first and second partitions 6, 7 will be
described. As described above, the first and second partitions 6, 7 fulfil an important
function of isolating the interiors of the hollow fiber membranes 5 from the ambience.
Generally, the partitions 6, 7 are produced by centrifugally casting a high molecular
potting agent of high polarity such as, for example, polyurethane, silicone or epoxy
resin, in the inner wall surfaces at the opposite ends of the first housing 1 and
allowing the cast potting agent to cure in place. To be more specific, a multiplicity
of hollow fiber membranes 5 of a length greater than the length of the first housing
1 are prepared and, with their opposed open ends filled up with a highly viscous resin,
disposed parallelly within the cylindrical main body 2 of the first housing 1. Then,
the opposite ends of the hollow fiber membranes 5 are completely concealed with mold
covers of a diameter greater than the diameter of the fitting covers 3, 4. The high
molecular potting agent is cast through the opposite ends of the first housing 1 at
the same time that the first housing 1 is rotated about its own axis. After the resin
has been cast and cured fully, the aforementioned mold covers are removed and the
outer surface portions of the cured resin are cut off with a sharp cutter to expose
the opposite open ends of the hollow fiber membranes 5 to view. Consequently, there
have been formed the first and second partitions 6, 7.
[0021] In the embodiment described above, since the hollow fiber bundle 15 is constricted
at the central portion by the constricting member 14 and expanded toward the opposite
ends thereof, the packing ratio of hollow fiber membranes 5 is increased in the squeezed
portion 16 and, at the same time, the individual hollow fiber membranes 5 are uniformly
dispersed inside the cylindrical main body 2. Consequently the oxygen gas is allowed
to form a uniformly dispersed, stable current as compared with the hollow fiber bundle
destitute of the squeezed portion 16. This means that the efficiency of exchange of
oxygen for carbon dioxide gas is improved. Further, since the internal cross section
of the first housing 1 is suddenly changed in the squeezed portion 16 at the center,
the flow rate of the oxygen gas in this portion is suddenly changed. Thus, the constriction
of the hollow fiber bundle 15 is effective in increasing the flow rate of oxygen gas
and heightening the speed of movement of the carbon dioxide gas as well.
[0022] The packing ratio of hollow fiber membranes 5 in the squeezed portion 16 is desired
to be fixed in the range of about 60 to 80% for the following reason. If the packing
ratio is less than about 60%, part of the hollow fiber membranes 5 escape being squeezed
by the constricting member 14. Consequently, the performance of the hollow fiber membranes
is impaired because they are unevenly distributed to an extent of inducing the phenomenon
of channeling. Further, there is posed a problem that the hollow fiber bundle 15 cannot
be accurately disposed at the center of the cylindrical main body with ease. If the
packing ratio is more than about 80%, those of the hollow fiber membranes 5 held in
direct contact with the constricting member 14 are depressed so powerfully as to be
crushed. Consequently, blood fails to flow through the crushed hollow fiber membranes,
lowering the overall efficiency of the hollow fiber bundle and inducing the phenomenon
of blood stagnation. Moreover, during the assemblage of the artificial lung part,
the constricting member 15 permits no easy passage of the hollow fiber bundle 15,
making the work very difficult.
[0023] The packing ratio of hollow fiber membranes inside the cylindrical main body 2 has
been fixed in the range of about 30 to 60% for the following reason. If the packing
ratio is less than about 30%, the hollow fiber membranes 5 are deviated to one side
in the interior of the cylindrical main body 2 and, consequently, the efficiency of
exchange of oxygen gas for carbon dioxide gas is degraded. The work involved also
becomes difficult. If the packing ratio is more than about 60%, mutual contact of
hollow fiber membranes 5 occurs and exerts an adverse effect upon the performance
of the hollow fiber bundle.
[0024] The packing ratio of hollow fiber membranes outside the first and second partitions
6, 7 has been fixed in the range of about 20 to 40% for the following reason. If this
packing ratio is less than about 20%, the uniformity of the distribution of hollow
fiber membranes 5 at the opposite open ends tends to be degraded by reason of workmanship.
Consequently, such problems as ununiform blood flow distribution and blood clotting
ensue. If the packing ratio is more than about 40%, mutual contact of hollow fiber
membranes 5 occurs and prevents the potting agent, the materials for the first and
second partitions 6, 7, from being evenly cast throughout the entire inner wall surfaces
at the opposite ends of the cylindrical main body. Consequently, the produced first
and second partions 6, 7 will suffer from leakage.
[0025] In the embodiment so far described, only the constricting member 14 is partially
projected from the inner wall surface of the first housing 1. This is not necessarily
the sole means of imparting required constriction upon the hollow fiber bundle. It
may be otherwise obtained by separately forming a ring-shaped constricting member
and fitting it in position on the interior of the cylindrical main body. It may be
obtained by forming an annular recess at the center of the cylindrical main body.
Optionally, the cylindrical main body may be gradually converged inwardly from the
opposite ends thereof so that the inside diameter thereof reaches its minimum at the
center and its maximum at the opposite ends.
[0026] The heat exchanger part B has a second housing 21 which comprises a cylindrical main
body 22 similar in shape to the first housing 1 of the artificial lung part A, fitting
covers 23, 24 provided respectively with heat-exchange medium inlet 29 and outlet
30 and each incorporating a male screw thread, and a blood port 31 containing a blood
outlet 33. Inside the second housing 21, a multiplicity of tubes 25 are mutually separated
and parallelly disposed in the longitudinal direction of the second housing 21, with
their opposite ends supported in position inside the fitting covers 23, 24 with third
and fourth partitions 26, 27 formed similarly with a potting material. The third and
fourth partitions 26, 27 define a heat exchange medium chamber 28 in conjunction with
the outer surfaces of the tubes and the inner wall surfaces of the second housing
21. Optionally, to the outer sides of the third and fourth partitions 26, 27 are respectively
attached a first end face member 44 and a second end face member 45. The tubes 25
are slender tubes measuring 1 to 3 mm in inside diameter, 0.05 to 0.2 mm in wall thickness,
and 50 to 300 mm in length and made of a thermally resistant, inexpensive material
having high thermal conductivity and high rigidity enough to escape being bent even
when molded in a small wall thickness. Preferably, the material is a metal such as
stainless steel.
[0027] The tubes 25 may be composed of such slender tubes 25a as described above and plastic
tubes 25b as illustrated in Fig. 2. In this case, the plastic tubes 25b of rigid resin
such as silicone or polyurethane with Shore A hardness of 95 to 98 measuring slightly
smaller in inside diameter than the outside diameter of the slender tubes 25a, about
1 mm in wall thickness, and 20 to 50 mm in length are slipped over the opposite end
portions of the slender tubes 25a of the aforementioned dimensions to a length of
about 5 mm each. These plastic tubes 25b are preferably made of a material having
chemical and physical properties approximating the corresponding properties of the
pressureproof partitions 26, 27 supporting in position the tubes 25. When the pressureproof
partitions 26, 27 are made of polyurethane, for example, the plastic tubes 25b are
desired to be made of polyurethane. When the material for the partitions 26, 27 and
that for the plastic tubes 25b have no affinity for each other as when the former
is polyurethane and the latter is polyethylene, for example, the surface of the plastic
tubes 25b must be treated so as to acquire affinity for the material of the slender
tubes 25a. To be specific, the outer surface of the plastic tubes 25b must be oxidized
with a suitable chemical or flame or subjected to a physical treatment by corona discharge
or plasma discharge, for example.
[0028] The shell-and-tube type heat exchanger B described above is produced as follows.
First, the tubes 25 having the plastic tubes 25b slipped over the opposite end portions
of the slender tubes 25a are prepared. Preferably, the openings at the opposite ends
of the slender tubes 25a are chamfered in advance. Then, 10 to 100 tubes 25 of an
identical size are bundled as one unit, with their opposed ends aligned correctly.
They are tied up by fastening elastic tubes such as, for example, rubber bands round
the opposite end portions of the bundled tubes. The space separating the adjacent
tubes 25 can be freely changed by suitably changing the wall thickness of the plastic
tubes 25b. Then, the openings at the opposite ends of the tubes are filled up. This
work of filling up the openings can be performed at any desired time before the insertion
of the tubes into the mold caps which is to be carried out as described fully afterward.
This filling work is not required when the plastic tubes 25b used on one end of the
slender tubes 25a have been sealed from the beginning. Thereafter the bundled tubes
25 are inserted into the second housing 21. In the meantime, mold caps each having
a cylindrical member of a smaller diameter fitted to the leading end of a cylindrical
member of a larger diameter are prepared. The mold caps are desired to be made of
such material as may be molded in a given shape and may then be easily cut with a
cutter. The inside diameter of the small-diameter cylindrical member of the mold cap
is equal to the overall outer diameter of the bundled tubes 25 and the inside diameter
of the larger-diameter cylindrical member of the mold cap is nearly equal to the inside
diameter of the fitting covers 23, 24 of the second housing 21. The small-diameter
cylindrical members of the mold caps are inserted so as to hold the bundled tubes
securely in position and the leading ends of the large-diameter cylindrical members
of the mold caps are wrapped round the end portions of the fitting covers 23, 24.
[0029] When the rigid resin is cast into the interior of the outer cylinder by the centrifugal
casting method, prevention of possible leakage of the rigid resin is desired to be
effected by preparing compression caps having an inside contour conforming with the
outside contour of the mold caps and fitting them on the mold caps already covering
the opposite ends of the outer cylinder so as to exert a compressive force upon the
opposite ends. Thereafter, the rigid resin such as silicone or polyurethane is cast
mold through the opposite ends of the outer cylinder into the interior of the cylinder
with the second housing 21 rotated about its axis for 15 to 20 minutes according to
the centrifugal casting method. The cast masses of the rigid resin, on being cured,
form the third and fourth pressureproof partitions 26, 27 which support the opposite
ends of the tubes fast in position at the opposite openings of the outer cylinder.
Then, the compression caps are removed from the opposite ends of the outer cylinder
and the pressureproof partitions and the molds now supporting the tubes fast in position
are cut perpendicularly to the axial direction of the outer cylinder to open the opposite
ends of the tubes.
[0030] When the slender tubes in the tubes which are supported fast in position by the pressureproof
partitions are made of metal, only the plastic tubes have to be cut. The slender metal
tubes, therefore, remain uncut and have no possibility of producing any burr.
[0031] Subsequently, the blood port 31 is fastened with the screw ring 42 to the fitting
cover 24 at one end of the second housing 21.
[0032] When the internal surfaces of the mold caps are coated in advance with a substance
incapable of adhering to the rigid resin, the mold caps can be easily separated from
the pressure-proof partitions 26, 27, making it no longer necessary to cut the partitions
26, 27 as covered with the mold caps. When the rigid resin is polyurethane, for example,
the internal surfaces of the mold caps may be coated with fluorine type resin to ensure
this easy separation of the mold caps.
[0033] In the artificial lung part A and the heat exchanger part B constructed as described
above, their opposed fitting covers 4, 23 have screw threads cut thereon in mutually
opposite spiralling directions as illustrated in Fig. 1. Through the medium of the
annular ring 37 provided on the periphery thereof with a protuberance 46, there fitting
covers 4, 23 are connected to each other with the connecting screw ring 36 fitted
round their outer faces so as to define the blood chamber 38 in conjunction with the
second partition 7 and the third partition 26. Through at least two injection holes
47 bored in the aforementioned screw ring 36 so as to communicate with the vacant
portion defined by the connecting screw ring 36, the second and third partitions 7,
26, and the annular spacer 37, the adhesive agent 48 is injected to fill up the aforementioned
vacant portion. The adhesive agent 48 thus filling the vacant portion fastens the
first and second housings 1, 21 and the connecting screw ring 36.
[0034] The protuberance 46 which is formed on the periphery of the annular spacer 37 may
be in the form of a continuous raised strip encircling the entire periphery of the
annular spacer 37. Optionally, the raised strip may be in a discontinuous form. Since
the protuberance 46 is intended to enable the annular spacer 37 to be positioned coaxially
with the housings 1, 21, it may be composed of three substantially equally spaced
raised points. It may be omitted when the annular ring 37 has a large wall thickness.
Even when this protuberance is omitted, there must be left a gap between the annular
ring 37 and the connecting screw ring 36 to permit insertion of a layer of the adhesive
agent. In the diagram of Fig. 1, 43 and 49 denote holes used as air vent or reserved
for some other purposes. These holes and the holes bored in the blood inlet 13 and
the blood outlet 33 have their respective caps 51, 52, 53 and 54 attached thereto.
[0035] The adhesive agent to be used in the present invention must be in a liquid or some
other similar state so as to exhibit ample flowability when it is injected through
the aforementioned holes 47 into the vacant portion. Thus, it is desired to be made
of rigid resin which exhibits high adhesiveness at least to the fitting covers 4,
23 and the connecting screw ring 36 and further to the second partition 7, the third
partition 26 (or the first end face member 44), and the annular spacer 37. As the
adhesive agent, a potting agent of high polarity such as, for example, polyurethane,
silicone or epoxy resin which is similar to the potting agent generally used to make
the aforementioned partitions 7, 26 is available. Particularly, polyurethane gives
desirable results.
[0036] Among the different types of polyurethane adhesive agents, the prepolymer adhesive
agent, the polyisocyanate adhesive agent and the isocyanate-modified polymer are advantageously
used. Generally, the prepolymer adhesive agent is a preferred choice. A typical prepolymer
adhesive agent is produced by mixing a prepolymer formed of 4,4'-diphenyl methane
diisocyanate and a bifunctional castor oil derivative (such as, for example, polypropylene
glycol ester of ricinoleic acid, having a molecular weight of 540) (with a NCO/OH
ratio in the range 1:1 to 1:1.5) with a cutting agent formed of a mixture of bifunctional
castor oil derivative, a polyfunctional polypropylene glycol (having a molecular weight
of 2,000 to 3,000, and an amino alcohol (50-70: 15-25: 15-25 by weight ratio) in a
weight ratio of 65:35 to 59:41, for example, so as to equalize substantially the numbers
of functional groups involved. This prepolymer adhesive agent is capable of cold curing,
possesses moderate elasticity, and excels in adhesiveness.
[0037] Fig. 3 represents another preferred embodiment of this invention, wherein O-rings,
specifically two O-rings 55 are placed to encircle the periphery of the annular spacer
37 as opposed to each other across the protuberance 46 and the vacant portion defined
by the second partition 7, the third partition 26, the connecting screw ring 36, and
the annular spacer 37 is filled with the adhesive agent 48. The O-rings and the confined
adhesive agent cooperate to enhance the tightness of the closure of the blood chamber
38. The same numerical symbols used in this diagram as those of Fig. 1 denote like
parts.
[0038] The embodiments of the invention described so far represent cases wherein the connecting
screw ring 36 is adopted as means for connection between the first and housing 1 and
the second housing 21. When the adhesive agent to be used possesses ample adhesive
strength, the connection of the two housings can be accomplished by using only the
adhesive agent. Then, it is no longer necessary to form screw threads on the connecting
ring and the fitting covers 4, 23. In this case, the parts being fastened with the
adhesive agent must be kept immobilized until the adhesive agent placed to fill the
vacant portion is completely cured. The connection can easily be attained by provisionally
fastening these parts with adhesive tape wrapped round joints of adjacent parts, then
filling the vacant portion with the adhesive agent, and peeling the adhesive tape
off the joints after the adhesive agent has been completely cured. The provisional
fastening of the parts may be effected by using molds of silicone rubber instead of
the adhesive tape.
[0039] Generally, the fitting cover 4 which constitutes the connecting end of the first
housing 1 and the fitting cover 23 which constitutes the connecting end of the second
housing 21 are desired to have an identical diameter. Of course, they can have two
different diameters as occasion demands. In this case, the corresponding halves of
the connecting ring 36 are required to have inside diameters matched to the different
diameters of the fitting covers 4, 23.
[0040] The heat exchanger-incorporated hollow fiber type artificial lung constructed as
described above is inserted in the external path for blood circulation and is operated
to bring about the same effect as the conventional heat exchanger and the artificial
lung which are inserted separately of each other. To be specific, the blood forwarded
by a pump (not shown) is introduced through the blood inlet 13, passed through the
interiors of the hollow fiber membranes 5 via the blood inlet chamber 12. During the
passage through the interiors of the hollow fiber membranes, the blood is divested
of carbon dioxide gas and oxygenated with the oxygen gas introduced via the gas inlet
9 into the oxygen chamber 8 and brought to the blood chamber 38. The oxygen gas in
the oxygen chamber 8 is discharged in conjunction with the released carbon dioxide
gas via the outlet 10.
[0041] On reaching the blood chamber 38, the blood is forwarded through the tubes 25. During
the passage through these tubes, the blood is heated or cooled with the heat exchange
medium such as hot water or cold water introduced via the medium inlet 29 into the
medium chamber 28. After the exchange of heat, the blood is brought to the blood outlet
chamber 32 and discharged via the blood outlet 33 to be subsequently returned to the
patient's body through the blood circulation path. The spent medium in the medium
chamber 28 is released via the medium outlet 30.
[0042] The flow of blood may be reversed when desired. In this case, the blood which is
heated or cooled in the heat exchanger part B and then oxygenated and divested of
carbon dioxide gas in the artificial lung part A is returned to the patient's body.
[0043] As described above, this invention concerns incorporation of a heat exchanger in
a hollow fiber type artificial lung. Since it finds no use for extra tubes otherwise
required in the connection of the two parts, it permits a decrease in the volume of
priming. Further, the deaeration of blood at the time of priming has only to be performed
just once and need not be effected independently and sequentially in the artificial
lung part and the heat exchanger part. This means that the time required for the assemblage
of the blood circulation path and the time spent for the deaeration of blood can be
cut notably. The possibility of incorrect connection between the artificial lung and
the heat exchanger is completely eliminated.
[0044] Since the artificial lung part and the heat exchanger part are joined with the adhesive
agent which is placed to fill the vacant portion formed by the second and third partitions,
the connecting ring, and the annular spacer, possible leakage of blood through the
lines or faces of junction can be prevented completely. Since the insertion of an
O-ring can be omitted, the possibility of blood leakage through the seat of a loose
0-ring is eliminated. The omission of the O-ring also contributed to cutting the cost.
The possibility of the connecting ring sustaining damage due to mechanical strain
is eliminated because the interior thereof is kept filled with the adhesive agent.
Even the formation of screw threads on the parts participating in the junction of
the two housings can be omitted. When these screw threads are omitted, the cost of
production can be notably lowered and the alignment of the gas port and the water
port becomes very easy.
1. A heat exchanger-incorporated hollow fiber type artificial lung comprising a hollow
fiber type artificial lung part (A) composed of a first housing (1), a hollow fiber
bundle (15) of a plurality of gas-exchange hollow fiber membranes (5) mutually separated
and parallelly disposed within said first housing (1) in the longitudinal direction
of the housing, a first (6) and a second (7) partition water-tightly supporting said
hollow fiber membranes (5) at the opposite ends thereof in a state not blocking the
openings of the membranes and further defining an oxygen chamber (8) in conjunction
with the inner wall of said first housing (1) and the outer surfaces of said hollow
fiber membranes (5), an oxygen inlet (9) and an oxygen outlet (10) communicating with
said oxygen chamber (8), and a blood passage communicating with the cavities in said
hollow fiber membranes (5) at the ends thereof at the side of said first partition
(6) remote from said oxygen chamber (8), and a shell-and-tube type heat exchanger
part (B) composed of a second housing (21), a plurality of tubes (25) mutually separated
and parallelly disposed inside said second housing (21) in the longitudinal direction,
a third (26) and a fourth (27) partition water-tightly supporting said tubes at the
opposite ends thereof in a state not blocking the openings of the tubes and further
defining a heat-exchange medium chamber (28) in conjunction with the inner wall of
said second housing (21) and the outer surfaces of said tubes (25), a heat-exchange
medium inlet (29) and a heat-exchange medium outlet (30) communicating with said heat-exchange
medium chamber (28), and a blood passage communicating with the cavities inside said
tubes at the ends thereof at the side of said fourth partition (27) remote from said
heat-exchange medium chamber (28), wherein said first housing (1) of said artificial
lung part (A) and said second housing (21) of said heat exchanger part (B) are coaxially
connected to each other so as to give rise to a blood chamber (38) between said second
partition (7) and third partition (26), said first (1) and second (21) housings having
connecting ends (4, 23) formed respectively thereon so as to be connected to each
other through the medium of an annular spacer (37) by virtue of a connecting ring
(36) fitted across the outsides of said connecting ends (4, 23) and, through at least
two injection holes (47) bored in said connecting ring (36) so as to communicate with
a vacant space defined by said connecting ring (36), said second (7), and third (26)
partitions and said annular spacer (37), adhesive agent (48) having been injected
to fill up said vacant space.
2. A heat exchanger-incorporating hollow fiber type artificial lung according to Claim
1, wherein said first and second housings (1, 21) severally possess connecting ends
(4, 23) of an identical diameter.
3. A heat exchanger-incorporated hollow fiber type artifical lung according to Claim
2, wherein said connecting ends (4, 23) of the first and second housings (1, 21) have
screw threads cut thereon in mutually opposite spiralling directions and the first
and second housings are connected to each other by virtue of a connecting screw thread
ring (36) fitted across the outsides of the connecting ends.
4. A heat exchanger-incorporated hollow fiber type artifical lung according to Claim
1, wherein said annular spacer (37) has a protuberance (46) formed on the periphery
thereof.
5. A heat exchanger-incorporated hollow fiber type artificial lung according to Claim
4, wherein said protuberance (46) is a continuous raised strip.
6. A heat exchanger-incorporated hollow fiber type artificial lung according to Claim
4, wherein said protuberance (46) is a raised strip in a discontinuous form.
7. A heat exchanger-incorporated hollow fiber type artifical lung according to Claim
4, wherein the gaps formed between said second (7) and third (26) partitions and said
annular space (37) each have an 0-ring (55) inserted therein.
8. A heat exchanger-incorporated hollow fiber type artificial lung according to Claim
1, wherein said adhesive agent (48) is a potting agent of high polarity.
9. A heat exchanger-incorporated hollow fiber type artifical lung according to Claim
8, wherein said potting agent is one member selected from the group consisting of
polyurethane, silicone and epoxy resin.
10. A heat exchanger-incorporated hollow fiber type artificial lung according to Claim
8, wherein said potting agent is polyurethane.
1. Künstliche Lunge des Hohlfasertyps mit eingebautem Wärmetauscher, umfassend einen
künstlichen Hohlfasertyp-Lungenteil (A) aus einem ersten Gehäuse (1), einem Hohlfaserbündel
(15) aus einer Vielzahl von Gasaustausch-Hohlfasermembranen (5), die gegenseitig getrennt
und im ersten Gehäuse (1) in dessen Längsrichtung parallel (zueinander) angeordnet
sind, einer ersten (6) und einer zweiten (7) Trennwand, welche die Hohlfasermembranen
(5) an ihren gegenüberliegenden Enden mit Wasserabdichtung in einem solchen Zustand
haltern, daß die Öffnungen der Membranen . nicht blockiert sind, und die weiterhin
zusammen mit der Innenwand des ersten Gehäuses (1) und den Außenflächen der Hohlfasermembranen
(5) eine Sauerstoffkammer (8) festlegen, einem Sauerstoffeinlaß (9) und einem Sauerstoffauslaß
(10), die mit der Sauerstoffkammer (8) kommunizieren, und einem Blutdurchgang, der
mit den Hohlräumen in den Hohlfasermembranen (5) an deren Enden an der von der Sauerstoffkammer
(8) entfernten Seite der ersten Trennwand (6) kommuniziert, sowie einen Hülsen-Röhren-Wärmetauscherteil
(B) aus einem zweiten Gehäuse (21), einer Anzahl von gegenseitig getrennten, im Inneren
des zweiten Gehäuses (21) in dessen Längsrichtung parallel (zueinander) angeordneten
Röhren (25), einer dritten (26) und einer vierten (27) Trennwand zur wasserdichten
Halterung der Röhren an deren gegenüberliegenden Enden in einem ihre Öffnungen nicht
blockierenden Zustand sowie weiterhin zur Festlegung eine Wärmeaustauschmediumkammer
(28) zusammen mit der Innenwand des zweiten Gehäuses (21) und den Außenflächen der
Röhren (25), einem Wärmeaustauschmedium-Einlaß (29) und einem -Auslaß (30), die mit
der Wärmeaustauschmediumkammer (28) kommunizieren, und einem mit den Hohlräumen im
Inneren der Röhren an deren Enden an der von der Wärmeaustauschmediumkammer (28) abgewandten
Seite kommunizierenden Blutdurchgang, wobei (dadurch gekennzeichnet, daß) das erste
Gehäuse (1) des künstlichen Lungenteils (A) und das zweite Gehäuse (21) des Wärmetauscherteils
(B) koaxial miteinander verbunden sind und damit eine Blutkammer (38) zwischen der
zweiten Trennwand (7) und der dritten Trennwand (26) bilden, erstes (1) und zweites
(21) Gehäuse jeweils angeformte Anschlußenden (4, 23) aufweisen, so daß sie über ein
ringförmiges Abstandstück (37) mittels eines über die Außenseiten der Anschlußenden
(4, 23) aufgesetzten Verbindungsrings (36) verbunden sind und über mindestens zwei
in Verbindungsring (36) ausgebildete Injektionsbohrungen (47) eine Verbindung mit
einem Leerraum vorliegt, der durch den Verbindungsring (36), zweite (7) und dritte
(26) Trennwand sowie das ringförmige Abstandstück (37) festgelegt ist, wobei eine
Klebmasse (48) zum Ausfüllen des Leerraums (in diesen) eingespritzt worden ist.
2. Künstliche Lunge des Hohlfasertyps mit eingebautem Wärmetauscher nach Anspruch
1, dadurch gekennzeichnet, daß erstes und zweites Gehäuse (1, 21), jeweils Anschlußenden
(4, 23) jeweils desselben Durchmessers aufweisen.
3. Künstliche Lunge des Hohlfasertyps mit eingebautem Wärmetauscher nach Anspruch
2, dadurch gekennzeichnet, daß in die Anschlußenden (4, 23) von erstem und zweitem
Gehäuse (1, 21) Schraubgewindegänge in zueinander entgegengesetzter Drehrichtung eingeschnitten
sind und erstes und zweites Gehäuse mittels eines auf die Außenseiten der Anschlußenden
aufgesetzten (aufgeschraubten) Verbindungsschraubrings (36) miteinander verbunden
sind.
4. Künstliche Lunge des Hohlfasertyps mit eingebautem Wärmetauscher nach Anspruch
1, dadurch gekennzeichnet, daß das ringförmige Abstandstück (37) einen an seinem Umfang
angeformten Vorsprung (46) aufweist.
5. Künstliche Lunge des Hohlfasertyps mit eingebautem Wärmetauscher nach Anspruch
4, dadurch gekennzeichnet, daß der Vorsprung (46) ein durchgehender (umlaufender)
hochgezogener Steg ist.
6. Künstliche Lunge des Hohlfasertyps mit eingebautem Wärmetauscher nach Anspruch
4, dadurch gekennzeichnet, daß der Vorsprung (46) ein hochgezogener unterbrochener
Steg ist.
7. Künstliche Lunge des Hohlfasertyps mit eingebautem Wärmetauscher nach Anspruch
4, dadurch gekennzeichnet, daß in die zwischen zweiter (7) und dritter (26) Trennwand
sowie dem ringförmigen Abstandstück (37) festgelegten Spalte jeweils ein O-Ring (55)
eingesetzt ist.
8. Künstliche Lunge des Hohlfasertyps mit eingebautem Wärmetauscher nach Anspruch
1, dadurch gekennzeichnet, daß die Klebmasse (48) eine Vergußmasse hoher Polarität
ist.
9. Künstliche Lunge des Hohlfasertyps mit eingebautem Wärmetauscher nach Anspruch
8, dadurch gekennzeichnet, daß die Vergußmasse ein Element der Gruppe aus Polyurethan,
Silikon und Epoxyharz ist.
10. Künstliche Lunge des Hohlfasertyps mit eingebautem Wärmetauscher nach Anspruch
8, dadurch gekennzeichnet, daß die Vergußmasse aus Polyurethan besteht.
1. Poumon artificiel du type à fibres creuses avec échangeur de chaleur incorporé,
comprenant une partie poumon artificiel (A) du type à fibres creuses composée d'une
première enveloppe (1), d'un faisceau (15) de fibres creuses comprenant une multiplicité
de membranes (5) de fibres creuses échangeuses de gaz séparées mutuellement et disposées
parallèlement à l'intérieur de ladite première enveloppe (1) dans le sens longitudinal
de l'enveloppe, des première (6) et seconde (7) cloisons supportant de manière étanche
à l'eau lesdites membranes (5) de fibres creuses par leurs extrémités opposées, dans
un état dans.lequel elles ne bloquent pas les ouvertures des membranes et elles délimitent
en outre une chambre à oxygène (8) conjointement avec la paroi intérieure de ladite
première enveloppe (1) et les surfaces extérieures desdites membranes (5) de fibres
creuses, une entrée d'oxygène (9) et une sortie d'oxygène (10) communiquant avec ladite
chambre à oxygène (8), et un passage pour le sang communiquant avec les cavités desdites
membranes (5) de fibres creuses par leurs extrémités, du côté de ladite première cloison
(6) le plus éloigné de ladite chambre à oxygène (8) et une partie (B) échangeur de
chaleur du type à calandre multitubulaire, composée d'une seconde enveloppe (21),
d'une multiplicité de tubes (25) séparés mutuellement et disposés parallèlement à
l'intérieur de ladite seconde enveloppe (21) dans le sens longitudinal de façon étanche
à l'eau lesdits tubes par leurs extrémités opposées, dans un état dans lequel elles
ne bloquent pas les ouvertures des tubes et elles délimitent en outre une chambre
(28) pour un milieu d'échange de chaleur, conjointement avec la paroi intérieure de
ladite seconde enveloppe (21) et les surfaces extérieures desdits tubes (25), une
entrée (29) pour le milieu d'échange de chaleur et une sortie (30) pour le milieu
d'échange de chaleur, communiquant avec ladite chambre (28) pour le milieu d'échange
de chaleur, et un passage pour le sang communiquant avec les cavités à l'intérieur
desdits tubes par leurs extrémités, du côté de ladite quatrième cloison (27) le plus
éloigné de ladite chambre (28) pour le milieu d'échange de chaleur, dans lequel ladite
première enveloppe (1) de ladite partie poumon artificiel (A) et ladite seconde enveloppe
(21) de ladite partie échangeur de chaleur (B) sont raccordées coaxialement l'une
à l'autre de manière à donner naissance à une chambre (38) pour le sang entre ladite
seconde cloison (7) et ladite troisième cloison (26) lesdites première (1) et seconde
(21) enveloppes comportant des extrémités de raccordement (4, 23) qui y sont formées
respectivement de manière à être raccordées l'une à l'autre par l'intermédiaire d'un
élément d'espacement annulaire (37) grâce à une bague de raccordement (36) montée
sur les faces extérieures desdites extrémités de raccordement (4, 23), et à travers
au moins deux trous d'injection (47) percés dans ladite bague de raccordement (36)
de manière à communiquer avec un espace libre délimité par ladite bague de raccordement
(36), lesdites seconde (7) et troisième (26) cloisons et ledit élément d'espacement
annulaire (37), un agent adhésif (48) ayant été injecté pour combler ledit espace
libre.
2. Poumon artificiel du type à fibres creuses avec échangeur de chaleur incorporé
selon la revendication 1, dans lequel lesdites première et seconde enveloppes (1,
21) possèdent individuellement des extrémités de raccordement (4, 23) de diamètre
identique.
3. Poumon artificiel du type à fibres creuses avec échangeur de chaleur incorporé
selon la revendication 2, dans, lequel, sur lesdites extrémités de raccordement (4,
23) des première et seconde enveloppes (1, 21), sont taillés des filetages dans des
sens hélicoïdaux mutuellement opposés, et les première et seconde enveloppes sont
raccordées l'une à l'autre grâce à une bague de raccordement filetée (26) qui est
montée sur les faces extérieures des extrémités de raccordement.
4. Poumon artificiel du type à fibres creuses avec échangeur de chaleur incorporé
selon la revendication 1, dans lequel ledit élément d'espacement annulaire (37) a
une protubérance (46) formée sur son pourtour.
5. Poumon artificiel du type à fibres creuses avec échangeur de chaleur incorporé
selon la revendication 4, dans lequel ladite protubérance (46) est une bande saillante
continue.
6. Poumon artificiel du type à fibres creuses avec échangeur de chaleur incorporé
selon la revendication 4, dans lequel ladite protubérance (46) est une bande saillante
de forme discontinue.
7. Poumon artificiel du type à fibres creuses avec échangeur de chaleur incorporé
selon la revendication 4, dans lequel, dans chacun des espaces libres formés entre
lesdites seconde (7) et troisième (26) cloisons et ledit élément d'espacement annulaire
(37), est inséré un joint torique (55).
8. Poumon artificiel du type à fibres creuses avec échangeur de chaleur incorporé
selon la revendication 1, dans lequel ledit agent adhésif (48) est un agent d'enrobage
de forte polarité.
9. Poumon artificiel du type à fibres creuses avec échangeur de chaleur incoporé selon
la revendication 8, dans lequel ledit agent d'enrobage est une membre du groupe composé
des polyuréthanes, des silicones et des résines époxy.
10. Poumon artificiel du type à fibres creuses avec échangeur de chaleur incorporé
selon la revendication 8, dans lequel ledit agent d'enrobage est un polyuréthane.